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UWorld MQ1 Flashcards

1
Q

HIV DRUG : NRTI

A

Zidovudine
Tenofovir
emtricitabine

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2
Q

NRTI MOA

A

inhibits HIV DNA synthesis from RNA template by terminating DNA chain elongation

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3
Q

NNRTI

A

EfaVIRenz
NeVIRapine

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4
Q

NNRTI MOA

A

allosteric RT inhibits: terminate DNA chain enlongation

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5
Q

PI drugs: Navir

A

Atazanavir
darunavir
ritonavir
indinavir

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6
Q

PI MOA

A

inhibits HIV poly protein cleavage

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7
Q

Integrase Inhibitor MOA

A

inhibits HIV DNA integration into host genome

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8
Q

Fusion inhibitor: binds to HIV gp41

A

EnFUvirtide

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9
Q

CCR5 antagonist: allosteric gp120 interaction

A

Maraviroc: blocking entry

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10
Q

how is resistance developed to NNRTIs

A

point mutation in RT region of Pol gene

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11
Q

gremlin mutation of VHL gene

A

AD
renal cell carcinoma
pheochrom
RB

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12
Q

Kayser-Fleischer rings in Wilson dz
Incre copper, dec ceruloplasmin

A

Cornea deposition
Treat with zinc and chelation(D-penicillinamine)

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13
Q

Breast fat necrosis clues

A

Post traumatic
Irregular mass
Central necrosis liquefactive fat
Neutrophil & macrophages

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14
Q

Breast: solitary firm round mass with clear borders, fibrous capsules, tan/white on cross section

A

Fibroadenoma

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15
Q

Cyclical premenstrual tender breast
Blue or brown fluid

A

Fibrocystic changes

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16
Q

Dysplastic nevus syndrome mutation

A

CDKN2A (p16)

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17
Q

multiple scattered skin lesions with irregular nuclear contours, round or spindle shape cells will develop

A

melanoma

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18
Q

DNA synthesis reaction begins in

A

cytoplasm
carbamoyl phosphate synthetase II

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19
Q

Antifungal: Cell wall

A

Caspofungin

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20
Q

antifungal: mitosis

A

Griseofulvin

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21
Q

anti fungal DNA& RNA synthesis

A

Flucytosine

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22
Q

Antifungal Cell membrane

A

Amphotericin B &Nystatin bind ergosterol

Azoles inhibit synthesis of ergosterol

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23
Q

single enlarged parathyroid

A

parathyroid adenoma
excess secretion of hormones causes hypercalcemia and neg feedback causing atrophy of other gland

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24
Q

MOA of vit A analog alter gene expression to

A

normalizes keratinization
decreased epithelial cohesiveness
stimulated stem cell mitosis

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25
Q

strongest risk factor for MI

A

smoking
oxidize LDL=accelerate atherosclerosis
increase catecholamine =vasoconstriction
vasculitis and endothelial cell dysfunction

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26
Q

pharm

Streptomycin
MOA

aminoglycoside

A

inactivatinng the 30S(small) Ribosomal Subunit

altered structure of bacterial ribosomal protient cause resistance

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27
Q

Rifampin MOA

A

Inhibition of bacterial DNA-dependent RNA polymerase

SE: Red-orange body fluids, cytopenia, GI effects

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28
Q

Isoniazid MOA

A

Inhibition of mycolic acid synthesis

Niacin defi(skin rash)

Neurotoxic(B6), hepatotoxicity

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29
Q

Pyrazinamide SE

Unclear MOA

A

Hepatotoxicity
hyperuricemia

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30
Q

Ethanbutol MOA

A

inhibition of arabinosyl transferase

Optic neuropathy

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31
Q

Increase activity of enzymes involved in cell wall polysaccharide synthesis

arabinosyl transferase

A

Ethambutol

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32
Q

Decreased activity of bacterial catalase peroxidase

inhibition of mycolic acid

A

INH

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33
Q

Altered the structure of enzymes involved in DNA winding-unwinding

A

Rifampin

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34
Q

2 phases of Hep B progression

A

Proliferative phase and integrative phase

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35
Q

To activate MHC I, HepB present with

CD 8 activation causes cytotoxic effect

A

entire virion, HBsAg and HBcAg on hepatocyte cell surface

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36
Q

appropriete med for long-term management of Bipolar

A

Lithium

Nephrogenic Diabetis, hypothyroid, chronic interstitial nephritis

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37
Q

treatment option of bipolar maintenance

A

lithium,
valproate,
lamotrigine

lithium may decr suicidal ideation

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38
Q

MALT Lymphoma may be cause by

A

chronic immune stimulation

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39
Q

mc trigger of gastric MALT lymphoma

A

H. pylori

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40
Q

Ecoli V. factor & function

Lipopolysaccharide

A

activates macrophages to
release IL-1, IL-6, TNF-a

septic shock/bacteremia

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41
Q

Ecoli V. factor & function

K1 capsular polysaccharide

A

prevents phagocytosis and complement-mediated lysis

Neonatal meningitis

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42
Q

Ecoli V. factor & function

Shiga toxin

A

block 60S: protein synthesis/cell death

Bloody diarrhea

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43
Q

Ecoli V. factor & function

heat-stable/heat-labile enterotoxins

A

promotes fluid
electrolytes secretion from intestinal epithelium

watery diarrhea

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44
Q

Ecoli V. factor & function

P-frimbriae

A

adhesion to uroepithelium

urinary tract infection

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45
Q

hi dose IL-2 MOA

produced by activated CD4/8 & NK cells

A

enhance activity of natural killer cells

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46
Q

IL-2 effect of cd4

proinflammatory

A

converts to T helper 1+–> IFN-Y/A, IL-2

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47
Q

IL-2 effect of CD8

A

expands pool of CD8 for cytotoxic killing

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48
Q

hypotension, tachycardia, dental erosion
electrolyte abnormalities

low K, metabolic alkalosis

A

Bulimia nervosa

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49
Q

minimal change pathogenesis

A

T Cell- mediated injury to podocytes

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50
Q

first line treatment for candida

A

fluconazole

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51
Q

resistance to fluconozole

A

Mutations altering the enzyme of cell membrane ergosterol synthesis

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52
Q

resistance to azole

A

eflux pumps
increase 14-alpha-demethylase
mutate 14-a-demthylase

14-a dm covert lanosterol to ergosterol

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53
Q

in B12 deficiency you are missing

A

succinly-CoA and
Methionine/THF

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54
Q

what build up in B12 defi

A

methylmalonyl-CoA
Homosysteine

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55
Q

digoxin is fat or water soluble

A

water soluble

cleared by kidney

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56
Q

inhibition of glycosyltransferase enzyme affects

A

Mycoplasma

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57
Q

function of bacterial glycosyltransferase enzyme

A

add glycan to peptidoglycan chain of cell wall

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58
Q

target mycoplasma with

A

tetracycline
macrolides

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59
Q

ubiquitinated TDP-43

found in

A

Frontotemporal demetial

altered executive function

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60
Q

difficulty moving post antipsychotic drug
HTN, fever

NT affected

A

dopamine

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61
Q

MOA

Benztropine

antipsychotic

A

Block D2 Negrostiatal pathway

drug-induced parkinsonism treat with anticholinergic medication

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62
Q

Disease progression in Ankylosis Spondy

most helpful measurement

A

chest wall mobility

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63
Q

cardioinhibitory response in syncopy

A

increase parasympathetic to SA/AV node

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64
Q

vasodepressor

vasodepressor response to syncopy

A

decreased sympathetic output to vascular smooth muscle causing dialation

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65
Q

cirrhosis pt with fluid in the lung

A

hepatic hydrothorax

fluid moving across diaphragm

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66
Q

phthirus pubis treatment

pubic louse

A

topical permethrin

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66
Q

function of aromatase

Dificiency in the placenta

A

converts androgens to estrogen

hi androgen during pregnancy-->ambigous external genetalia

Maternal and female fetus verilization

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67
Q

If pt can’t use aspirin

alternate antiplatelet irreversible blocks P2Y-ADP receptor

A

clopidogrel

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68
Q

use to prevent cardiovascular event

A

Aspirin
clopidogrel

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69
Q

cilostazol moa

treats?

A

phospodiesterase inhibitor

claudication: peripheral vascular dz

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70
Q

cytocine deamination DNA repair sequenes

base excision repair

A

glycosylase
endonuclease,
lyase,
polymerase
lygase

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71
Q

synergistic activity of simvastatin and cholestyramine

A

cholestyramine— increase cholesterol syn
simvastatin—Inhibit cholestrol syn

lowers cholesterol

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72
Q

what is Programmed-death receptor 1(PD-1)

A

used by cancer cells to downregulate
cytotoxic T-cell

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73
Q

MOA of Pembrolizumab

A

blocks PD-1
restore CD 8 T-cell killing ability

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74
Q

trisomy 21 Cardiac presentation

A

AV septal defect
VSD
ASD

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75
Q

trisomy 21 GI

A

duodenal atresia
hirschsprung dz

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76
Q

trisomy 21 oncology

A

acute leukemia

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77
Q

trisomy 21 orthopedic

A

atlantoaxial instability

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78
Q

trisomy 21 neuro

A

intelectual disability
alzheimer dz

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79
Q

Amiodaron

Class III SE

A

Bradycardia
hepatic toxic
thyroid dysf

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80
Q

Metoprolol

SE

A

Bradycardia
advanced AV block

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81
Q

Adenosine

MOA hyperpolarize nodal pacer

A

flushing/Low BP
Bronchospasm
Hi-grade AV block

initial PSVT treament

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82
Q

Digoxin

SE

A

Bradycardic
Nausea & vomiting
yellow vision halo

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83
Q

Verapamil/diltiazem

Ca+ Blocker

A

bradycard
AV blocker
low ventricular contraction
constipation

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84
Q

ibutilide/dofetilide/sotalol

SE

A

Torsade de pointes

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85
Q

mc ectopic electrical foci causing A. Fib

A

pulmonary vein

treat with ablation

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86
Q

Treat Warfarin OD with

A

Vit K
FFP

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87
Q

treat heparin OD with

A

Protamin sulfate

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88
Q

lack of ApoE3 and ApoE4, lipid-laden macrophages shows inpairment of

A

chylomicron remnat uptake by liver cells

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89
Q

misattributing undesired thoughts or feeling to another person

A

projection

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90
Q

incomplete obliteration of the vitelline duct

A

meckel diverticulum

true diverticulum: mucosa, submucosa and muscularis

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91
Q

dz causing verying severity of maternal line

A

heteroplasmy

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92
Q

dz with AD patern causing varying severity

A

variable expression

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93
Q

Ecoli LPS bind to _______________-and activate NF-kB to transcribe _____________________

A

Toll-like receptor (PRR)
Proinflammatory (TNF-a, IL-1, IL-6, IL-12)

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93
Q

incident of spinal stenosis may result from enlargment of _____________ligament

A

ligmentum flavum

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94
Q

3 component of RAAS regulation

A

Macula densa
intrarenal baroreceptors
beta-adrenergic receptors

B1 blocks renin release

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95
Q

when etiology of Met. alkalosis is unknow, assess

A

volume status
urine chloride

low CL- impairs renal excretion of HCO3

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96
Q

primarily manic, may have depressive episodes

hospitalizaiton or marked social impairment

A

Bipolar I

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97
Q

major depression,
Hypomanic >4 days,
observable change from functioning baseline

no psychotic feature, no hospitilization

A

Bipolar II

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98
Q

responsible for wound reepithelization

A

keratinocytes

contact inhibition controls growth

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99
Q

lack of facial expression and monotone voice + psychotic symp.

neg symptom: flat affect

A

schizophrenia

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100
Q

pharyngitis and tonsillitis with grey-white pseudomembranes

Treatment

A

Diphtheria antitoxin**
Antibiotic

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101
Q

moa of DT exotoxin

booster vac. every 10 years

A

irreversibly inhibits host protein syn

ADP-ribosylation of EF-2

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102
Q

spherules containing endospores describes

parts of central and south America

A

coccidioides immitis

dimorphic fungus:

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103
Q

disruption of tissue O2 delivery by oxidizing agents

increase Lactic acidosis

A

Methemoglobinemia
(Nitrites, chloroquine)

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104
Q

cyanide tox of nitroprusside moa

A

blocks TCA electron trasport

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105
Q

pain in SI and pubic symphysis during pregnancy may be dt

A

relaxin prduction

by corpus lutium and placenta

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106
Q

Histology of pulmonary edema

A

engorged capillaries and alveoli filled with acellular pick material

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107
Q

histology of lung of pt with heart failure demostrate

A

hemosiderin-laden macrophages

leak from alveolar capillaries

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108
Q

presence of hi neutrophils in alveolar fluid

A

exudative alveolar
bacterial pneumonia

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109
Q

Goodpasture / vasculitides lung histology

histology presentation

A

focal necrosis of alveolar walls
intra-alveolar hemorrhage

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110
Q

Treatment

defective platelet surface glycoprotein receptor

binds finbrinogen in platelet aggregation

A

abciximab

Txt: unstable angina, acute coronary syndrome..: GP2b/3a antagonist

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111
Q

Defective outward K flow and prolongation of action potential causes ? Cardiac presentation

Amiodarone, sotalol, dofetilide (K blocker)

A

ventricular Tach & sudden death

congentital long QT syndrome

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112
Q

Which cytokines is proinflammatory

A

IL-12–> IFNy, IL-2, TNFa (Th1)
IL-17(Th17)

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113
Q

Anti-inflammatory cytokines

A

IL-4, IL-10(Th2)
Treg (IL-10, TGFb)

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114
Q

proinflammatory release from T helper 1

A

IFNy
TNFa
IL-2

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115
Q

association b/t exposure to risk modifier (treatmt) and outcome (disease course)

A

Exposed/non-exposed

RR

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116
Q

why is barium constrast studies and colonoscopy contraindicated in toxic megacolon(UC)

A

Risk of perforation

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117
Q

children with limited Iron intake first show decrease in which lab findings

A

Ferritin

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118
Q

parasite blood fluke infection

chronic hepatosplenomegaly, bladder cancer, anemia and hi eosinophile

asia, subsahara Africca

A

schistosomiasis

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119
Q

UTI

Nitrate reductase-producing bacterial

A

Ecoli,
Klebsiella,
proteus mirabillis

Plus Urease=proteus mirabillis

120
Q

UTI

Bacteria incubation

incease bacteria #: false neg with low bacterial count in UA

A

allow for Nitrite pos result

accumulation of bacterial metabolites

121
Q

common neoplastic colonic polyps is

A

sessiele serrated polyp
adenomatous (villous>tubular)

122
Q

Non-neoplastic common colonic polyps is

A

Hyperplastic
inflammatory
Hamartomatous

123
Q

attrition bias is a form of _________________ resulting from disporportionate loss of reseach subject in follow-up

A

selection bias

124
Q

MCC of acute otitis media

A

Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis

Bulging/ruptured TM with purulence in middle ear

125
Q

agent that increase natriuresis and sustained decrease in serum AT II and aldo production

A

B-blockers
direct Renin inhibitor
ACE inhibitor

126
Q

sphingomyelinase moa

Niemann-pick

A

spingomyelin(phospholipid) to ceramide

hepatosplenomegaly, foam cells cherry-red macula(retinal opacity)

127
Q

progressive neurodegeneration, macula opacity, G m2(ganglioside)

A

B-Hexosaminidase
Tay-Sachs ds

128
Q

hi dose dexa suppresses with ACTH hi

129
Q

All antidepressants carry risk of _______________.

A

inducing mania

EG: Sertraline

130
Q

predisposure to giardia result from

A

secretory IgA production

131
Q

infant is diaphoretic with high-pitched cry, vomiting and loose stools

exposure to which drug

132
Q

presentation of antigens processed in lysomoes

A

HLA-DR+ (MHC II)

absence impairs B and T activation

133
Q

Hi AChE in amniotic fluid

Hi AFP

A

fusion of edges of neural plate
neural tube defect

134
Q

low AFP and normal AChE levels in amniotic fluid

A

Down Syndrome

135
Q

Lab

hi IgE
eosinophil
normal leukocyte with low Th17

A

hyper-IgE syndrome

136
Q

pathogenesis

Hyper-IgE

A

AD
Defective JAK-STAT–low Th17
low neutrophil/chemotaxis

137
Q

Hyper IgE present with

A

noninflammatory abscesses (cold)
recurrent sinopulmonary infection
chronic atopic dermatitis

138
Q

withdrawal

seizures, tachycardia, palpitations

tremors, agitation, anxiety, delirium

A

alcohol & Benzo

139
Q

withdrawal

NVD, lacrimation, yawning, dialated pupil abdominal craping

140
Q

withdrawal

hyperphagia, psychomotor retardation, severe depression, hi appetite

A

stimulants
cocaine, amphetamines (ADHD)

141
Q

prefers to be alone, detached, unemotional

142
Q

prefers to be alone for fear of criticism and rejection

143
Q

cresent formation on Renal biopsy on light microscopy is

A

anti-GBM, linear deposition of IgG, C3

144
Q

Goodpasture syndrome

A

glomerulonephritis and pulmonary hemohrrage

145
Q

aortic root dialation dt marfan syndrome

best heard

A

right upper sternal border

end of expiration w pt leaning forward

146
Q

best heard

Aortic regurgitation murmur dt valvular pathology

bicuspid/rheumatic hrt dz

A

left third intercostal space

end of expiration w pt leaning forward

147
Q

beta-oxidation, TCA, carboxylation of pyruvate occurs in

A

mitochondria

148
Q

Glycolysis, fatty acid synthesis, and pentose phosphate pathway occurs

A

in cytosol

149
Q

contracted while cleaning animal waste from barn

SOB, fatigue, myalgias, retroorbital headaches

A

coxiella burnetii

Q fever from animal shit

150
Q

dense DNA in nucleus

A

low transcription
heterochromatin

151
Q

symptomatic management of alzheimer dz

A

NMDA receptor antagonist(memantine)
cholinesterase inhibitors(donepezil, galantamine)

152
Q

Alzheimer disease pathogenesis

A

loss of cholinergic neurons–Memory
B-amyloid–diffuse cortical atrophy

153
Q

Actinic keratoses histology

sun-exposed region

A

atypical keratinocytes-hyperchromatic
scattered mitotic figures

154
Q

infectious RNA molecure purified from virus capable of protein synthesis and gene replication is

A

pos sense single-stranded

eg Rhinovirus

155
Q

healthy 6 week old with frequent emesis with no PE finding

A

physiologic low tone of the LES

156
Q

Tolcapon & Entacapon MOA

Tolcapone is also central

A

anti COMT incr levodopa

prevent levodopa breakdown in periphery

157
Q

carbidopa MOA

A

anti DOPA decarboxylase
inhibit levodopa—>dopamine

158
Q

cardiac auscultation in left decubitus position on full expiration =presystolic sound

A

left ventricular hypetrophy

S4

159
Q

ecoli

Lipid A is also called

A

LPS
endotoxin

septic shock

160
Q

elbow pain dt pulling up childs arms cause by

A

radial head dislocation and impingement of the annular ligament

161
Q

cervical posterial lymph node biopsy may affect

A

spinal accesory
trapezius & SCM

162
Q

first-line pharm for moderate-to-severe alcohol use disorder

A

opioid antagonis naltrexone

pt who need help dealing with cravings

163
Q

pulsatile GnRH secretion during puberty may result in

A

increase estrogen–>precocious puberty

shorter female

164
Q

pathogenesis

5-a reductase def

A

46 XY
impaired conversion of testosteron to DHT

hi T and no DHT

165
Q

5a-reductase presentation

A

teenage girl with primary amenorrhea
blind vagina
internal male sx organs

166
Q

complete defect in androgen receptor function

presentation

A

phenotypic female with absent internal female genital ducts
primary amenorrhea
internal male genital duct absent
gynecomastia expected

167
Q

Drug involve with chelation resulting in decreased absorption

cation effect

A

Tetracyclines
Fluoroquinolones
Levothyroxine

Cation: Iron, Ca++, Mg++, Aluminum…..

168
Q

single base substitution with normal Lysine for Histidine

A

Hemoglobin F

less affinity for 2,3 BPG incr O2 affinity

169
Q

Where are serotonergic neurons found

A

Raphe Nuclei of brainstem

170
Q

Where is raphe nuclei located

A

midbrain, pons, medulla
with axon projection thoughout CNS

171
Q

SSRI function of neurons found in

Eg: Fluoxetine

A

Raphe nuclei

Anxiety

172
Q

acute and painless monocular vission loss is characteristic

A

Central retinal artery occlussion

Cherry-red macula

173
Q

abnomal presence of endometrial glands and stroma

A

adenomyosis

174
Q

adenomyosis present in

A

multiparous pt with dysmenorrhea
heavy menses
uniformly enlarges uterus

175
Q

benign myometial smooth muscle, heavy mensis nontender and irregularly enlarged uterus

A

Leiomyomas(uterine fibroids)

176
Q

Risk factors of acute ARDS

A

Sepsis, pneumonia
Trauma
pancreatistis

177
Q

Acute ARDS

pathophysiology

A

insult–> cytokine release–>hi neutrophil–> hi capillary permeability–> alveolar fluid increase–wipeout surfactant–hyaline membrane formation

increase functional residual capacity

178
Q

pt with renal condition must avoid which opioid

179
Q

opioid tox in pt with renal condition is dt

A

accumulaton of morphine active metabolites that are renally cleared

180
Q

prokaryotes :ecoli

DNA pol 1 function

A

5’ -3’ enxonuclease that removes RNA primer

inhibition impairs growth

181
Q

very flexible body, contortionist, skin bruises and scar easily

defect

182
Q

defective fibrillin-a is a

A

AD
Marfan syndrome

183
Q

hypermobile joint, overelastic skin, bruis, wound easy

A

Ehlers-Danlos syndrome

184
Q

M

Monoamine oxidase inhibitors (MAOIs)

A

Phenelzine
tranylcypromine

antidepressant: inhibit oxidative deamination

185
Q

MAOIs function

A

increase presynaptic
NorEpi
Dopamine
Serotonin

186
Q

mood reactivity
leaden paralysis
rejections sensitivity
incre sleep/appetite

A

major depressive disorder with atypical features

187
Q

MOAIs can be used to treat

A

treatment-resistant major depressive disorder

188
Q

Organism that burrows in the epidermis

A

Scabies –human itch mites

Treat: Topical permethrin

189
Q

MOA

effective treatment for pulmonary arterial hypertention

Bosanten and ambrisentan

A

Blocking the endothelin receptor

190
Q

name 2 growth factors involve in angiognensis in neoplastic/granulation tissue

A

VEGF and FGF

191
Q

growth factor

proinflammatory cytokines can also stimulate expression of

IL-1 and INF-Y

192
Q

what may pose a physical barrier to sprouting new bld vessels

A

laminin in basement membranes

193
Q

MOA of

Programmed cell death protein -1 (PD-1)

A

Binds T, B and NK cell
down reg activity

prevent T-cell exhaustion with PD-L1

194
Q

when PD-1 bind receptor

A

it decrease IL-2

195
Q

next step in pt with xantholasma

A

check serum lipids and blood glucose level

196
Q

virus that cause neuroinvasive disease meningitis, encephalitis and flaccid paralysis

A

West Nile virus

197
Q

cardic conduction speed

A

AV Node .05 m/sec
Ventricular m. 0.3m/s
Atrial m. 1.1m/sec
purkinje system 2.2m/s

198
Q

MOA of

TMP
methotrexate
Pyrimethamin

A

inhibit dihydrofolate reductase

decrease formation of THF

199
Q

CGG repeats in fragile X is

what mechnism

A

Methylation-induced gene silencing

200
Q

ethiology of prerenal acute kidney injury

A

anything the decrease renal perfusion (BP)

201
Q

Which beta blocker is effective for pt with chest pain and COPD

cardia selective

A

metoprolol, atenolol, bisoprolol, nebivolol

202
Q

pt with MI and COPD

why avoid non-cardioselective beta blockers

A

trigger bronchospasm

propranolol, nadolol …..

203
Q

complication of anorexia nervosa

A

osteoporosis
amenorrhea
hair loss
parotid hypertrophy
hypotention, hypothermia, bradicardia
cardiac atrophy, arrhythmias

204
Q

damaged ipsilateral lateral geneculate body affect

A

ipsilateral temporal hemiretina

204
Q

protease inhibitor defi
affecting elastin

target

A

interchain cross-links involving lysine

alpha-1 antitrypsin defi

205
Q

thoracocentesis is typically performed bwt rib

A

6th and 8th midclavicular
8th & 10 midaxillary
10th 12th paravertebral

below righ 9th risk penetrating the liver/abdominal organ

206
Q

prolong use of B-blocker and withdrawer

A

upregulation of B-adrenergic receptor and enhance response

207
Q

increase in left ventricular wall stress may result in

incre O2 demand

A

slow-rising carotid pulse, mid-systolic murmur, large pressure gradient

severe aortic stenosis

208
Q

baby with subdural and retinal hemorrhage suspect

A

abusive head injury

209
Q

early prenancy vaginal bleeding and no fetal cardiac activity

A

partial hydatidaform mole

69, XXX or XXY

210
Q

duadenal ulcer primarily associate with

A

H. Pylori

Gastric antrum

211
Q

progressive loss of peripheral vision w hi intraocula pressure

A

open-angle glaucoma

212
Q

glaucoma pt

carbonic anhydrase inhibitor and Timolol targets

nonselective beta blockers

A

ciliary epithelium

decrease aqueous humor

213
Q

glaucoma pt

decrease eye presure and increase outflow of aqueous humor by

A

Pg F2a (lantanoprost, travoprost)

cholinomimetics (pilocarpine, carbachol)

214
Q

to preseve left ventricular ejection fraction

changes

A

Cardiomyocyte hypertophy

215
Q

Lung exam

Nomal lung

Breath sounds, tactile fremitus and percussion

A

Normal
Normal
Resonance

216
Q

consolidation

Breath sounds,
tactile fremitus
percussion

A

Increased
increased
Dullness

217
Q

Pleural effusion

Breath sounds,
tactile fremitus
percussion

A

decreased/absent
Decreased
Dullness

218
Q

pneumothorax

Breath sounds
tactile fremitus
percussion

A

decreased/absent
Decreased
Hyperresonance

219
Q

Atelectasis

Breath sounds,
tactile fremitus
percussion

A

Decreased or absent
Decreased
Dullness

220
Q

Pt with DM1.

adrenal insufficiency

what is the elctrolyte abnormalities

A

low NA
hi K
Hi Cl-
nonanion gap metabolic acidosis

hypoaldo

221
Q

MG associated with thymus

Thymus and __________________ arise from third pharyngeal pouch

A

inferior parathyroid glands

222
Q

transplant patient

only fungus appearing red on mucicarmine stain and clear on india ink

A

cryptococcus neoformans

223
Q

Hormones that binds zinc finger domaine

A

Thyroid and lipid-soluble like estrogen, aldo, cortisol and fat

224
Q

Transudative effussion has Low/Hi LDH compare to Exudate

225
Q

painless solid testicular mass

alway supect

226
Q

Area under the PO curve divided by area under the IV curve =

A

Bioavailability

227
Q

MOA of oxandrolone post burn

A

anabolic steroid use to protein synthesis

decrease pt musce wasting due to increase metabolic rate

228
Q

surgery

damage to which structures will result in voice pitch limitation

A

superior laryngeal nerve invervating the cricothyroid ms

229
Q

MOA of the systemic progestins

combine hormonal contracptive

A

suppresses GnRH & pituitary
gonadotropin secretions
inhibiting ovulation

230
Q

MOA of the locally-acting progestins

progestin-only pill, Levonorgestrel IUD

A

Thickens cervical mucus
imparing sperm penetration

231
Q

MOA of Copper IUD

A

causes chronic cytotoxic inflammed uteres, imparing sperm migration

232
Q

Enzyme defect?

infant with open anterior fontanelle and soft with overlying fine, white hair
abnormal optic nerve and foveal development

A

AR: Tyrosinase
oculocutaneous albinism

impair melanin synthesis

233
Q

chronic allergic contact dermatitis histology

reaction nickle

A

intercellular epidermal edema with infiltration
of lymphocytes and eosinophil

234
Q

complication of vesicoureteral reflux

A

acute pyelonephritis
Reflux nephropathy

retrograde urine flow causing recurrent infection

235
Q

MOA of death cap (amanita phaloides)

A

Amatoxin inhibites RNA pol. II

directly inhibites mRNA

236
Q

clinical association of atopic dermatitis in children

A

Allergic rhinitis
Asthma
Food allergy

Lab: Hi IgE and eosinophils

237
Q

Aspirin in children with viral infeciton causes

A

Reye syndrome
microvesicular steatosis

PE: hepatomegaly, hi transaminase, may progress to seizure and coma

238
Q

most common cause of unilateral hearing loss in adults

cerebellopontine angle tumors

A

vestibular schwannnoma

located bwt cerebellum and lateral pons

239
Q

Bilateral vestibular schwannomas are associated
with

A

neurofibromatosis type 2

240
Q

defective primary neurolation lab shows

A

increase AFP

241
Q

What is the measure of potency of inhaled anesthetic

A

Minimal alveolar concentration (MAC)

low MAC=high potency

242
Q

physiology of

ganglion cyst

A

(mucoid) degeneration of periarticular tissue

243
Q

MOA of penecilamine therapy

A

binds copper and increase urinary copper excretion

244
Q

location of RNA polymerase I

A

exclusively in the nucleolus

transcribe 18S, 5.8S,and 28S rRNAs

245
Q

function of RNA polymerase II

A

trascribe mRNA, snRNA and miRNA in the nucleus

246
Q

hi ammonia and orotic acid

enzyme

A

ornithine transcarbamylase

247
Q

MOA of PCP

superstrenght, hallucinaition and movement disorder

A

N-Methyl-D-aspartate receptor antagonist
may cause Dopamin disregulation

and inhibit serotonin, dopamin and norepi reuptake

248
Q

reactivation of CMV causes

A

colitis in HIV pt
biopsy: inflammaotry infiltrate, mucosal necrosis,

ovoid nuclei with basophalic deposit

249
Q

MOA of protease inhibitor

A

block viral protease from
cleaving gag-pol polyprotein

produces immature virus

250
Q

early marker for abnormal phosphate metabolism in pt with chronic reanal disease

A

increase serum fibroblast growth factor 23

increase in response to hyperphos dt CKD

251
Q

pathway of alkaptouria

A

Tyrosine to fumarate

252
Q

homogentisic acid dioxygenase defect

A

build up : Homogentisate

253
Q

indication of lithium

A

bipolar with Manic & deprssive features

DI (arginine vasopressin restist) ebstein anomaly, tremor, lo thyroid

254
Q

indication of valproate

A

bipolar with manic features

SE: hepatotox and teratogenic

255
Q

indication of carbamazepine

A

bipolar with manic features

SAIDH, neural tube defect, aplastic anemia

256
Q

indication of Lamotrigine

A

Bipolar with Depressive features

benign rash, Steven-johnson syndrome

257
Q

protrusion of the tongue

258
Q

horseness: muscle of larynx mostly innervated by

vocal cord

259
Q

Nerve

anterior 2/3 of tongue
parasympa: salivary gland secretion from submandibular and sublingual

A

corda tympani branch of CN 7

260
Q

afferent of gag reflex and sensory to posterior 2/3 of tongue

261
Q

general sensation to carotid body carotid sinus and tonsillar region

262
Q

esophagus

a motility disorder caused by reduced numbers of inhibitory ganglion cells

A

Achalasia

decreased amplitued of peristalsis and Incease LES tone

263
Q

Reversible acute confusion, fluctuating levels of consciousness

264
Q

altered mental status

gradual progression irreversible (loss) of consciousness. spared remote memory;

265
Q

rigor mortis is failure to

A

relax
myosin head detachment from the actin filament

calcium-and ATP -driven process: cross-bridge cycling

266
Q

promising option pregnancy in Downs and turner syndrome

A

In Vitro fertilization

267
Q

risk factor for vibrio

A

open wound in marine environment and Iron overload condition

C. Jujuni, vibrio like Iron

268
Q

short acting nonbenzodiazepin hypnotic agent

GABA agonist

A

zolpidem,
zaleplon,
eszopiclone

269
Q

absent elevation of the testicle with stroking of the ipsilateral thigh

A

testicular torsion

270
Q

(ERBB2) HER2 expression indicate

A

aggressive disease

271
Q

secondary reaction causing epithelia tissue damage from type 1 hypersensitivity

A

major basic protein initiated by IgE

late phase

272
Q

most common pediatric arrhythmia

narrow QRS complexe

A

supraventricular tachycardia

elevated heart rate regular rhythm

273
Q

most likely cause of SVT

A

Shortening of the ventricular diastole

less time for relaxation

274
Q

preventing catheter related UTI

A

avoid unessesary use and remove promptly

275
Q

rectal bleeding/pain with ulcerated or nodular anal mass

A

Human papilomavirus

dark, irregular nuclei with keratinization

276
Q

contact dermatitis

pt with allergy due to hair product

A

type 4 H.sensitivity

277
Q

```

~~~

short acting B 2 agonist

A

albuterol
levalbuterol

278
Q

long acting beta 2 agonist

A

salmeterol
formoterol

279
Q

Renin level in primary hyperaldo

adrenal adenoma

280
Q

elevated aldo and renin suggest

A

2ndary hyperaldo

enovascular disease and renin-secreting tumors

281
Q

in-hospital Treatment for PE

A

Low-molecular-weight heparin

282
Q

Thayer-martin selective medium contains

A

vancomycin, colistin, nystatin and trimethoprim

283
Q

Thayer-martin medium is use

A

Neisseria organisms Identification

284
Q

AIDs : CD4 :30, progressive motor deficite, confusion

Reactivation of

285
Q

most effective drug for hypertriglyceridemia

A

Fibrates (fenofibrate)

286
Q

Treatment of hi triglyceride causing pancreatis

activate peroxisome PPAR-a

A

fenofibrate

increse lipoprotein lipase..induces HDL syn

287
Q

1.

cause of early cataracts formation

A

prednisone exposure
DM
ocular trauma
external radiation exposure

288
Q

longterm use of Hydroxychloroquine

For SLE

A

low central visual acuity
photopsia(flashing light)
central macular degeneration

289
Q

Drugs associated with SAIDH

ADH production & increase renal ADH sensitivity

A

carbamazepine
SSRI
chlorprapamide(antidiabetic)
recreational drugs(MDMA: ecstasy)

Low serum na and osmo

290
Q

Lithium renal effect

A

ADH resistance

low urin osmo, high serum osmo and Na

291
Q

nonpainful, nonpruritic skin colored lesion, cerrucious vulgaris

292
Q

histologic description of HPV

A

thickening stratum cornneum
epidemal hyperplasia & papilloma formation
cytoplasmic vacuolization(koilocytosis)

293
Q

pelvic fractures are frequently associated with

A

posterior urethra valve injury
bulbomembranous junction
high rising boggy prostate
urethra blood

294
Q

fabrous band extending from cecum and right colon to retroperitoneum

compressing duodenum

A

Ladd band

midgut malrotation and intestinal fixation

295
Q

MG pt may be resistant to which anesthetic

A

depolarizing agents (succinylcholine)

competitive agonist of Nicotinic receptor. less receptor available

296
Q

MG pt are extremely sensitive to which anesthetic

removal of mediastinal mass

A

nondepolarizing agent (vecuronium, rocuronium)
less receptors available

small does induces paralysis loss airway patency

297
Q

greatest risk for multiple myeloma

A

Amyloidosis
deposition of insoluble Ig light-chain

298
Q

atraumatic Splenic rupture is risk for

A

leukemia and lymphoms

massive spleomegaly

299
Q

use to detect and quatify mRNA in sample

Step 1 Clues (27 decks)

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